TimingThink it through. Your baby needs you most during his first year, and it’s a year that will never come again. Can you take a leave of absence? Take out a loan? Some mothers ask for an “early inheritance” or loan from family, since the need right now is so great and there may be no need at all in later years. Can you go back part-time for a while – either for a couple of full days or 5 half days a week? Will your income be worth it after daycare, transportation, clothing, convenience foods, and the extra work and worry of separation? Could you bring your baby full- or part-time for a few months? Can some of the work be done at home? Mothers with even the most inflexible job requirements often find surprising ways to combine working and mothering. When you do start back, begin on Thursday, if you can, and take the next Wednesday or two off. That way, you’ll work no more than two days in a row while you both adjust to your new routine.
EquipmentFind a way to express milk that suits you. Talk with nursing friends, La Leche League or a certified lactation consultant. Every method has its pros and cons. Hand expression is free and needs no equipment, but takes some practice and requires concentration. Hand pumps are very portable, but also require concentration and probably will not yield as much as a rental pump. Small electric pumps don’t have the durability of rental pumps and may not be able to pump both sides at the same time. Rental pumps are efficient, comfortable, and very easy to double pump with, but are bulky and may require an outlet. If you’ll be pumping for several months, they cost about $1 a day (compared with about $3 plus added doctor bills for formula), and the cost can perhaps be shared with a nursing co-worker. Steer clear of pumps made by companies who make other, non-breastfeeding products; their reputation doesn’t depend on the quality of their pumps and the quality is unlikely to be good enough for you
Childcare Before you return to work, look for a supportive caregiver whose mothering style matches yours – someone who will hold or wear your baby as much as possible, especially during feedings, who will use your milk and check with you before offering anything else, who will be flexible, and who will avoid giving your baby a big meal just before you’re due to arrive. Some mothers prefer a caregiver close to home; others look for someone close to work. If your caregiver won’t be taking your baby outside, make sure to do so a few times a week, even just to run errands; direct daylight is needed for vitamin D production
Expressing Your MilkCan you go to the baby to nurse on your lunch hour or break? Can the baby be brought to you, by the sitter or by someone else? Would you rather have two shorter breaks or one long lunch hour? To supply all your baby’s needs, you’ll probably need to express your milk two or three times during a full work day. (Some mothers like to pump one side first thing in the morning, so they already have one bottle.) As your baby gets older, he may prefer waiting for you over taking a bottle. Most babies will want to nurse more at night – their way of making up for lost time with you during the day – so use naps or an earlier bedtime to meet your own sleep needs. Your total milk supply depends more on how much you nurse at home than how much you pump at work. Does your baby seem to need more and more milk while you’re gone? Look first for ways to slow his meals down; he is probably looking for more sucking time, not more calories. Stay flexible, and take your baby’s changing patterns into account.
Storing Your Milk
As soon as you’re comfortable doing so, start storing small amounts of milk in the freezer. Many mothers find morning the easiest time to express extra milk, perhaps nursing on one side while they pump on the other. It can be frozen in any kind of clean container or bottle bag. If you use bags, keep them in a larger container to protect them from punctures and smells. You can add to already-frozen milk if the milk you add is cold, but storing in small amounts (no more than 2 ounces at first) lets the sitter thaw only what’s needed, so there’s less waste. Label the milk with the date, and keep it toward the back of the freezer for the coldest temperature. At work, most women express their milk on Monday for Tuesday’s feedings, on Tuesday for Wednesday’s, and so on, refrigerating it or keeping it in a cooler with “blue ice” containers at work until they take it to the sitter’s. Friday’s milk is saved for the next Monday, and over the weekend they don’t pump at all. Milk can be refrigerated for several days or frozen for several months. The oldest milk should be used first. A “soapy” smell is sometimes related to freezing and rarely bothers the baby. Milk should be thawed under warm running water, not on a stovetop or in a microwave, then shaken to re-mix. If you feel your supply needs boosting, you should feel comfortable taking a few “sick days” to stay home and do plenty of nursing. After all, you have a higher priority now than perfect attendance! Call a La Leche League Leader or certified lactation consultant with questions.
Supplements Some mothers combine breastfeeding and formula. Remember that even a little formula given in the early months alters a baby’s system and cuts into the benefits of human milk. On the other hand, even a little breastmilk improves the nutrition and health of a mostly formula-fed baby. Using formula will reduce your milk supply, and can result in an earlier weaning than you would like. But even one or two nursings a day mean an irreplaceable “immunization” for your baby – especially important in group daycare – and an important relationship for both of you. If you decide you must use formula, the less formula the better.
Bottles Almost all babies will gradually accept a bottle if it’s not forced on them, and if someone other than Mom offers it. Standard, old-fashioned style bottle teats are usually a better choice than modern shapes that encourage a baby to suck with “prissy lips”. Wait until you and your baby are a happy nursing couple before experimenting with bottles. They were designed to replace breastfeeding, and sometimes they do! There are other ways to feed a baby as well, like using a small cup, so if bottles are beginning to damage your breastfeeding relationship, contact La Leche League or a certified lactation consultant for suggestions.
Working Mothers’ Rights As you begin making arrangements with your employer, explain that you will be breastfeeding, rather than asking permission. You’ll probably be surprised by the positive response. Almost all countries recognize a mother’s right to be with her baby. The American Academy of Pediatrics recommends exclusive breastfeeding for about 6 months, with continued nursing to at least a year. The Innocenti Declaration, signed by the United States and other countries in 1990, states that “…all women should be enabled to practise exclusive breastfeeding and all infants should be fed exclusively on breastmilk from birth to 6 months of age. Thereafter, children should continue to be breastfed, while receiving appropriate and adequate complementary foods, for up to two years of age or beyond. This child-feeding ideal is to be achieved by creating an appropriate environment of awareness and support so that women can breastfeed in this manner… All governments… should have… enacted imaginative legislation protecting the breastfeeding rights of working women and established means for its enforcement.”
You have a recognized right to breastfeed your baby. If you need help protecting that right, contact your physician, La Leche League, or a certified lactation consultant.
©2000 Diane Wiessinger, MS, IBCLC www.normalfed.com